Provider Demographics
NPI:1013369982
Name:ASHAKIH, JASMIN
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:ASHAKIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 POMONA RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3049
Mailing Address - Country:US
Mailing Address - Phone:734-709-6205
Mailing Address - Fax:
Practice Address - Street 1:2488 GOLFSIDE RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1383
Practice Address - Country:US
Practice Address - Phone:734-709-6205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010871631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical